MENTAL HEALTH AND SUBSTANCE USE

Katherine Mills

My hope is that people with substance use disorders can get the right treatment and not be turned away or feel ashamed.

Roughly one-third of Australians with substance abuse problems have a concurrent mental illness. Katherine Mills is figuring out why, and leading world-first trials of innovative treatment programs.

More than one in four Australians will develop an alcohol or other drug use disorder over their lifetime. For approximately one-third, their recovery will be complicated by the presence of a co-occurring mental disorder, most commonly relating to depression, anxiety or psychological trauma.

In treatment settings, the co-occurrence of these conditions – typically referred to as comorbidity – is more the rule than the exception. In fact, it’s estimated that up to 80% of people in treatment for substance abuse issues also have a mental health condition.

It's clear the two disorders are intimately linked, but stigma still deters many people who need help from seeking it.

“We have come a long way in reducing the stigma associated with mental illness, but the same cannot be said for attitudes towards people struggling with their alcohol or other drug use,” says Associate Professor Katherine Mills from the NHMRC Centre of Research Excellence in Mental Health and Substance Use at UNSW's National Drug and Alcohol Research Centre.

“But the fact is, these substance use conditions are absolutely no different to other mental disorders or physical illnesses, such as diabetes and heart disease.”

Even if a person does seek help, clinicians are unsure how to treat them: “There is very little in the way of research to guide treatment responses,” says Mills. “As a result, people often end up being bounced between services, receiving disjointed and uncoordinated care, and in some cases falling between the cracks.”

At the Centre of Excellence, Mills works with more than 70 international experts studying the two conditions to try to better understand how they’re related and how they should be treated.

She has led world-first trials of innovative treatments, particularly in the area of co-occurring substance use and post-traumatic stress disorder.

It’s an incredibly important goal, when you consider the toll of these conditions on society.

Mental health and substance abuse disorders affect some 300,000 Australian adults each year, and they are the leading disease burden among people aged 15 to 24.

In adults, the impact of these two conditions is only overtaken by cancer and cardiovascular disease.

While treatment trials are vital to improving care, Mills says it is equally important that healthcare professionals and patients are provided with evidence-based resources to help them make informed decisions about treatments.

Mills has developed a range of resources for clinicians – to help them choose optimal treatments for different patients and circumstances – and for patients, family members and the general public, to teach them how to recognise symptoms and provide information on where to go for help. These educational tools are used in Australia and internationally.

“It takes incredible strength to seek treatment for mental and substance use disorders,” says Mills. “My hope is that people with substance use disorders can get the right treatment and not be turned away or feel ashamed."

“My hope is that we will have a range of effective treatments for mental and substance use disorders, and a service system that will allow for the right treatment to be delivered to the right person at the right time.”